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D Fiere

Publications and source records attributed to D Fiere.

At least 91 records · Page 5Linked to original sources
PubMed1987

Surface markers in acute non-lymphoid leukemia: analysis with a panel of 36 monoclonal antibodies.

The reactivity of a panel of monoclonal antibodies was studied in fifty-four cases of acute myeloid (AML) or undifferentiated (AUL) leukemias. Thirty-six antibodies from the Myeloid section of the Second Workshop on Human Leukocyte Differentiation Antigens were used in an indirect immunofluorescence assay. The antibodies could be classified into three groups recognizing respectively granulocytic, monocytic or granulomonocytic leukemias. Most antibodies stained erythroblastic and megakaryoblastic leukemias. In each group, it was possible to define antibodies staining either the less differentiated forms (FAB M 1 and M 5 a) or the more differentiated forms (M 2, M 3, M 4 and M 5 b). Six out of eight AUL were stained by some of the antibodies (mainly from the monocytic group). However, a heterogeneity of stainings in a same blast population was observed.

Acute Disease↗
PubMed1987

Day 4 bone marrow aspirate for prediction of resistance to induction chemotherapy in acute myeloid leukemia.

Bone marrow aspirate was performed on day 4 of a 7-day induction chemotherapy regimen using daunorubicin, cytosine arabinoside and thioguanine in 42 patients with acute myeloid leukemia (AML). The mean percentage of remaining abnormal cells in day 4 bone marrow was significantly higher in patients having resistant disease (RD) than in patients entering complete remission (CR). Except for patients with FAB M3 AML, most patients who had more than 40% abnormal cells in their day 4 bone marrow had RD. In addition, patients entering CR despite having more than 40% abnormal cells remaining in their day 4 bone marrow seemed to have short CR.

Adolescent↗
PubMed1987

Adult acute lymphoblastic leukaemia: is cell proliferation related to other clinical and biological features?

Flow cytometry with propidium iodide and fluorescein isothiocyanate was used to study 46 cases of adult acute lymphoid leukaemia (ALL) before any form of chemotherapy. Cell proliferation was related to the other clinical and biological characteristics and its prognostic significance was evaluated. The following cell-cycle variables were determined: S, G2 + M, and the Low Protein Content fraction of G1 (LPC fraction). The L3 group, corresponding to B-ALL, had significantly higher proliferation than L1 and L2 (P less than 0.01). The proliferation rate was not significantly higher for T-ALL than for the other phenotypes. Complete remission was successfully induced significantly more often in cases with the LPC fraction under 50% (P less than 0.05). Failure was mainly related to resistance to chemotherapy. Of the four patients who died during aplasia, three had an LPC fraction below 25%. Duration of complete remission and survival were significantly shorter for L3 which is the most proliferative ALL (P less than 0.01). Survival was also found to be longer (P less than 0.05) when G2 + M was between 3.8% and 5.1%. This finding and the negative correlation between S and G2 + M (P less than 0.01) are discussed.

Adolescent↗
PubMed1987

Expression of a B-lymphoid differentiation antigen (CD 19) on acute non-lymphoblastic leukaemia cells.

The expression of CD 19 (B4) surface antigen was investigated in 41 cases of acute myeloid leukaemia (AML), and 8 cases of acute undifferentiated leukaemia (AUL). Diagnosis was carried out by usual cytological and cytochemical means, and leukaemias were classified according to the FAB classification. CD 19 antigen is thought to be expressed on B lymphoid cells only. However, 2 cases out of 9 FAB M1, M2 and M3 subtypes were weakly stained (20 to 25%) by B4 antibody; 7 out of 11, and 17 out of 18 cases of M4 and M5 subtypes were markedly stained (25 to 70% of cells). 3 cases of AUL were also stained. Moreover, B4 expression was often correlated with expression of monocyte-associated antigens, as recognized by CRIS6, My9, KiM1 and UCHM1 antibodies. It is concluded that B4 antigen is probably expressed before B differentiation and is retained in early stages of monocytic differentiation.

Antigens, Neoplasm↗
PubMed1987

[Bronchiolitis caused by graft versus host reaction after bone marrow allograft].

Graft versus host reaction (GVH) is a major complication of allogenic marrow transplants. The GVH present is a pluri-visceral syndrome in which certain pulmonary disorders are recognised. Amongst these respiratory failure by bronchiolitis is not an exceptional presentation. The case reported here is of an 18 year old man who developed, immediately following a marrow graft for acute lymphoblastic leukaemia, a lethal obstructive respiratory failure after progression for 2 1/2 years. The respiratory function data (TVO with elevated residual volume (VR) and VR/Total lung capacity (CT) hypoxia which corrected on exercise with normocapnia then hypoxic hypercapnia; compliance normal at low frequency but fell at high frequency and inspiratory and expiratory resistance was raised: DLCO/VA was normal) allowed the confirmation of obstructive respiratory failure by disease of the small airways. The pathogenesis of CVH is equivocal. Recurring infections seem to play a role, favoured by iatrogenic factors such as chemotherapy and total body irradiation. In the case reported here the first pulmonary signs followed an episode of influenza with sero-conversion.

Adolescent↗
PubMed1987

Influence of daunorubicin and cytarabine sequencing on the outcome of therapy in acute myelogenous leukemia: a randomized trial.

Ninety-seven patients less than or equal to 70 years of age with previously untreated primary acute myeloblastic leukemia were randomly treated with either the DAT or TAD regimen: daunorubicin (70 mg/m2/day) administered on Days 1-3 (DAT) or 5-7 (TAD) of a 7-day sequence consisting of cytarabine (200 mg/m2/day) and 6-thioguanine (200 mg/m2/day). Complete responders received consolidation, maintenance, and final intensification over 14 months using mostly the same drugs as during induction and administered in the same sequence. The regimens did not significantly differ from each other with regard to toxicity or efficacy. Complete remission rate was 80% in the two groups, and median duration of complete remission was 549 days with DAT and 518 days with TAD.

Adult↗
PubMed1986

[Allogenic bone marrow grafts in acute myeloid leukemias. A retrospective study in 111 grafted patients in first complete remission].

Between 1978 and 1984, in 13 French Transplant Centers, 111 patients with acute myelogenous leukaemia underwent allogeneic bone marrow transplantation while in first complete remission. The conditioning regimen consisted of cytoxan 60 mg/kg X 2 and 10 Gy total body irradiation. To prevent graft-versus-host disease, 75% of the patients were given methotrexate and 25%, cyclosporine A. The probability of remaining in complete remission was 61% at 5 years. The probability of survival was 43% at 5 years, with a plateau between 2.5 and 6 years. The most frequent causes of death were interstitial pneumonia, relapses and graft-versus-host disease. Relapses were more frequent in cases with M 4-5 cytology than in those with M1 to M3 cytology (P less than 0.01). Transplant-related deaths were mainly consecutive to graft-versus-host disease and its facilitating effect on pneumonia (P less than 0.05). These results indicate that bone marrow transplantation can cure a large proportion of patients with acute myelogenous leukaemia, especially AML subtypes without monocytic differentiation. Improvements in conditioning regimens for the M 4-5 subtypes and in prevention of graft-versus-host reaction and cytomegalovirus infection should give rise to further developments in this field.

Adolescent↗
PubMed1986

Cell-cycle prognostic value in adult acute myeloid leukemia. The choice of the best variables.

Flow cytometry with simultaneous analysis of DNA and protein content allows a most exhaustive study of cell-cycle for the prognostic evaluation of acute myeloid leukemia (AML). Sixty-seven cases of AML were studied before any form of chemotherapy had been undertaken. We determined the following cell-cycle variables: S, S + G2 + M, low protein content fraction (LPC-fraction) and high protein content fraction of G1 (HPC-G1). Patients were stratified according to age: S and S + G2 + M phases were higher for patients over 50 who did not achieve a complete remission. LPC-fraction was significantly lower for patients older than 50 who did not achieve a complete remission not only compared to the complete remission group of patients over 50, but also compared to the younger non responder group. The duration of survival was significantly longer when LPC-fraction was higher than 26% and HPC-G1 lower than 70%. Length of survival was also better when S + G2 + M was longer than 5.75%. Analysis of the therapy failure showed that S + G2 + M and LPC-fraction were significantly different between the complete remission group and the group of patients dying in aplasia. Overall, patients older than 50 with a proliferative leukemia had a worse prognosis.

Adolescent↗
PubMed1986

A sequential study of histological and immunological changes in the skin after allogenic bone marrow transplantation.

Histological and immunopathological studies were performed on serial skin biopsies from thirteen recipients of allogenic and two recipients of autologous bone marrow transplants. Marked dermoepidermal infiltration with Leu 2a+ (OKT8+) phenotype cells was found in two patients with severe graft-versus-host disease, but the infiltration did not precede clinical onset of the graft-versus-host disease. Absence of Langerhans cells was noted during the early posttransplant period in recipients of both allogenic and autologous transplantation. Intercellular epidermal staining with anti-DR was observed in three cases, without relation to graft-versus-host disease.

Adolescent↗
PubMed1986

Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80).

Ninety-seven patients with aggressive malignant lymphoma (ML) were treated with an intensive and sequential chemotherapy (protocol LNH-80). There were 42 patients with intermediate grade ML, 53 patients with high-grade ML, and two patients with true histiocytic ML. Most of the patients were in advanced stage: 21 stage III and 61 stage IV. The LNH-80 protocol schedule comprised three phases: (1) induction with three courses of an intensified CHOP-Bleo (cyclophosphamide, doxorubicin, vindesine, methylprednisolone, and bleomycin); (2) consolidation with cytarabine, followed by high-dose methotrexate and folinic acid rescue, then asparaginase; and (3) final intensification with two courses of CVAP-Bleo (cyclophosphamide, teniposide, cytarabine, methylprednisolone, and bleomycin). CNS prophylaxis included one injection of methotrexate during each induction course and the drugs of the consolidation phase. In cases of initial CNS localization, cranial radiotherapy was added. Eighty-four patients (87%) went into complete remission (CR), 18 (21%) of whom relapsed, usually during the phase of treatment or within 6 months of completing chemotherapy. Sixty-three patients are alive with an overall median follow-up of 24 months. The median survival time and the median disease-free survival have not been reached, and the survival curve seems to have plateaued at above 60%. There was no statistical difference between intermediate-grade ML (CR 90%, relapse 18%) and high-grade ML (CR 84%, relapse 24%). The toxicity of this treatment is mainly encountered during the induction phase: almost all patients had short-term neutropenia, less than 0.500 g/L in 57, with a documented infection in 25. Overall treatment-related mortality was 6%, with four patients dying during the induction phase.

Adolescent↗
PubMed1985

Cell-cycle, protein content, and nuclear size in acute myeloid leukemia.

Simultaneous analysis of DNA and cellular proteins provides information on cell proliferation and metabolism. Cellular protein content coupled with nuclear geometric parameters can be used to evaluate cellular maturation and differentiation. In this study, leucoblasts from 50 cases of adult acute myeloid leukemia were analyzed by flow cytometry, and semiautomatic morphometry was performed on bone marrow smears. Ethanol-fixed bone marrow blast cells were stained for DNA with propidium iodide (PI) and for proteins with fluorescein isothiocyanate (FITC). On the resulting FITC versus PI histograms we defined the cells with low protein content which are associated with a nonproliferating subpopulation (LPC fraction). Low protein content fraction and S-phase are correlated (p less than 0.01). The LPC fraction values are more dispersed than S-phase values and thus should indicate more clearly eventual differences between cellular populations. This hypothesis has been tested with the prognostic significance of cell-cycle variables: The LPC fraction was significantly higher in the complete remission group than in the other (p less than 0.01), while S-phase did not show any difference. The peak value of the protein content histograms is significantly lower in the granulocytic leukemias (M1, M2, M3) than in the leukemias with a monoblastic component (M4, M5). Furthermore, we showed that the differentiation and the maturation of the myeloid blast cells modify the nuclear size. The combination of these two parameters provides useful information for cytological classification.

Adolescent↗